Government targets and organisational change have been blamed for 'disappointing' staff survey results from ambulance trusts.
Last week's Healthcare Commission survey highlighted the poor relationship between senior managers and staff, but in ambulance trusts the problem was particularly stark.
Ambulance trust staff were found least likely to agree with the statement: "Senior managers here try to involve staff in important decisions". Eight of the 10 lowest-performing trusts were from the ambulance sector.
Ambulance trusts comprised eight of the worst 10 trusts for communication between senior managers and staff. The worst five trusts for senior managers involving staff in important decisions were also from the ambulance service.
Sam Oestreicher, secretary of Unison's national ambulance sector committee, said staff were coming under too much pressure to meet the new response time target, which came into force this month.
He said staff were being forced to cancel leave and work through meal breaks. Members "don't always think that management argues in their favour", added Mr Oestreicher.
Ambulance Service Network interim director Phil Selwood said the results were disappointing.
He said shift working and the fact that staff were often working outside trust grounds made regular communication between managers and workers difficult.
Merging 29 ambulance trusts into 12 had added to the challenge as staff were spread across bigger geographical areas, he said. He hoped results would improve as the changes bedded down.
He called on senior managers to create protected time with staff and communicate through briefings, newsletters and line managers.